The main objective of the Alabama Pregnancy Risk Assessment Monitoring System (PRAMS) Project is to provide accurate data to researchers, health care providers, and policymakers in order to ultimately improve the health of Alabama mothers and babies. This is in accordance with the Alabama Department of Public Health mission to improve the health of all Alabamians. The design and methods of the PRAMS project include drawing a sample from the state birth certificate registry file in a timely manner and sending surveys, on time, according to protocol, to the mothers who are selected. The survey contains information relating to behaviors and experiences before, during, and after pregnancy.